| Objective:To analyze the relationship between the clinical features of nail psoriasis,related influencing factors,laboratory tests and dermoscopic features and the severity of the disease,in order to provide clues for the early diagnosis and treatment of nail psoriasis,reduce the severity of the disease and improve the quality of life of patients.Methods:In this study,clinical data information of psoriasis patients from the platform of the National Clinical Medical Research Center for Skin and Immune Diseases and the Department of Dermatology of the Affiliated Hospital of Guilin Medical College were collected between October 2021 and December2022,and dermoscopic images were collected from patients with psoriasis A in our center.All data were analyzed using SPSS26.0 statistical software.Results:(1)The prevalence of nail psoriasis patients in this study was 36%,and the proportion of males,elderly,smokers,and late-onset psoriasis(>40years)was higher in the nail psoriasis group than in the no nail psoriasis group(P<0.05).(2)The proportion of combined and refractory sites of nail psoriasis was higher in the nail psoriasis group compared with the no nail psoriasis group(P<0.05).(3)40.8%of patients with nail psoriasis had combined co-morbidities,with the highest prevalence of cardiovascular disease(15.9%)and diabetes mellitus(11.5%),and the proportion of nail psoriasis combined with cardiovascular disease,diabetes mellitus,liver disease and respiratory disease was higher in the nail psoriasis group than in the nil psoriasis group(P<0.05).(4)The PASI,BSA,and DLQI scores were higher in the nail psoriasis group compared with the no nail psoriasis group(P<0.05).(5)Logistic regression analysis showed that male[OR=2.188,95%CI(1.182-4.05)],palmoplantar[OR=3.086,95%CI=1.781-5.346]and genital involvement[OR=2.302,95%CI=1.216-4.358]were influential factors for nail psoriasis.(6)Laboratory findings were not statistically significant between groups with and without nail psoriasis.(7)The duration of nail psoriasis was correlated with PASI(r_s=0.24),BSA(r_s=0.204),target nail NAPSI(r_s=0.216),and total target nail NAPSI(r_s=0.222)(P<0.05).(8)The number of nail involvement correlated with BSA(r_s=0.239),NAPPA(r_s=0.272),target nail NAPSI(r_s=0.572),target toenail NAPSI(r_s=0.558),and total target nail NAPSI(r_s=0.692).(9)The most common target nail was punctate depression(68.6%);the most common target toenail was hyperkeratosis under the nail(73.7%).(10)When comparing the damage characteristics of the target nails,the NAPSI scores were higher in patients with perineural scaling,perineural soft tissue erythema,nail roughness and brittleness,nail hemimelia,nail hyperkeratosis,nail sublinear hemorrhage,and nail separation(P<0.05);the PASI scores were higher in patients with perineural soft tissue erythema,nail scaling,nail hemimelia,and nail sublinear hemorrhage(P<0.05);and the PASI scores were higher in patients with nail hemimelia(P<0.05).);BSA scores were higher in patients with nail hallux valgus,nail subungual hemorrhage,and nail sulcus-like soft tissue erythema(P<0.05).Conclusions:(1)The elderly,smokers and patients with late-onset psoriasis are more likely to have concomitant nail damage;patients with nail psoriasis have more severe disease and poorer quality of life.(2)Male,palmoplantar,and genital involvement may be influential factors in nail psoriasis.(3)The duration of nail damage was positively correlated with PAIS,BSA,target nail NAPSI and total target nail NAPSI scores;the number of nail involvement was also positively correlated with BSA,NAPPA,target nail NAPSI,target toenail NAPSI and total target nail NAPSI.(4)Dermoscopic features of target nail damage may correlate with target nail NAPSI,PASI,and BSA scores and may be considered as a reference indicator of disease severity. |
